Individual provider Active NPI

Jerri Lynn Dunn, LCSW

  • Clinical Social Worker
  • Paducah, KY
National Provider Identifier
1750405825
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
254533 Issued in KY
Practice address
425 Broadway St Ste 201
Paducah, KY 42001-0713
Phone
(270) 442-7121
Fax
(270) 442-9775
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 007443 IA
Clinical Social Worker 1041C0700X 34006754A IN
Clinical Social Worker 1041C0700X 254533 KY Primary

Addresses

Primary practice location

425 Broadway St Ste 201
Paducah, KY 42001-0713

Mailing address

425 Broadway St Ste 201
Paducah, KY 42001-0713
Phone (270) 442-7121

Other practice location 1

1818 Went Ave
Suite A
Mishawaka, IN 46545-6482
Phone (765) 288-1982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1750405825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 BROADWAY ST STE 201",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420010713",
            "telephone_number": "270-442-7121",
            "fax_number": "270-442-9775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 BROADWAY ST STE 201",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420010713",
            "telephone_number": "270-442-7121",
            "fax_number": "270-442-9775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1818 Went Ave",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465456482",
            "country_code": "US",
            "telephone_number": "765-288-1982",
            "fax_number": "574-254-0188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNN",
        "first_name": "JERRI",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "007443",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006754A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "254533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.